Isolated unruptured aneurysm of the left coronary sinus of Valsalva

An isolated unruptured aneurysm of the left coronary sinus of Valsalva was detected incidentally in a patient with a bicuspid aortic valve in whom the left circumflex coronary artery arose from the right coronary artery. With the patient on cardiopulmonary bypass, the mouth of the aneurysm was closed by suturing the reflected posterior cusp of the aortic valve to the aortic root. A Starr-Edwards prosthetic aortic valve was inserted, and an aortocoronary saphenous vein bypass graft maintained good blood flow down the left anterior descending coronary artery. Previous reports of this rare condition and its treatment are discussed.